How much rates vary
Facilitymedian $2,291 · 10th to 90th $257 to $4,898Professionalmedian $224 · 10th to 90th $145 to $447
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $173.78 Median $2,511.89 Typical High $7,762.47 | Facility | None | $173.78 | $2,511.89 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $436.52 | Professional | None | $147.91 | $223.87 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $549.54 | Professional | None | $316.23 | $501.19 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $467.74 | Professional | None | $190.55 | $229.09 | $467.74 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $398.11 | Professional | None | $234.42 | $234.42 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $338.84 Typical High $676.08 | Facility | None | $100.00 | $338.84 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $478.63 | Professional | None | $128.82 | $234.42 | $478.63 |
Emblem Health Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $575.44 | Facility | None | $131.83 | $181.97 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $630.96 | Professional | None | $309.03 | $338.84 | $630.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $323.59 | Professional | None | $186.21 | $229.09 | $323.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $275.42 Median $616.60 Typical High $1,698.24 | Facility | None | $275.42 | $616.60 | $1,698.24 |
Highmark BCBS Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $363.08 | Professional | None | $263.03 | $309.03 | $363.08 |
MVP Health Care Setting Facility Modifier None Typical Low $173.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $173.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $478.63 | Professional | None | $144.54 | $144.54 | $478.63 |
United Setting Facility Modifier None Typical Low $354.81 Median $1,148.15 Typical High $4,365.16 | Facility | None | $354.81 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $398.11 | Professional | None | $109.65 | $199.53 | $398.11 |
Univera Setting Facility Modifier None Typical Low $125.89 Median $257.04 Typical High $512.86 | Facility | None | $125.89 | $257.04 | $512.86 |
Univera Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $323.59 | Professional | None | $186.21 | $257.04 | $323.59 |
15 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $109.65 Typical High $128.82 | Professional | 52 · Reduced service | $74.13 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $44.67 Typical High $52.48 | Professional | 53 · Discontinued | $29.51 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $165.96 Typical High $194.98 | Professional | 54 · Surgery only | $112.20 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $22.39 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.79 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $154.88 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $104.71 | $154.88 | $181.97 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $295.12 | Professional | 54 · Surgery only | $169.82 | $239.88 | $295.12 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $18.62 | $26.92 | $32.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.92 Typical High $32.36 | Professional | 56 · Pre-op care only | $18.62 | $26.92 | $32.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $213.80 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $151.36 | $213.80 | $263.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $141.25 | $177.83 | $204.17 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $302.00 | Professional | 54 · Surgery only | $169.82 | $239.88 | $302.00 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.92 Typical High $37.15 | Professional | 55 · Aftercare only | $18.62 | $26.92 | $37.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $26.92 Typical High $37.15 | Professional | 56 · Pre-op care only | $18.62 | $26.92 | $37.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $213.80 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $151.36 | $213.80 | $269.15 |
Where New York sits
The same service costs 3.4 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 45th of 51
$229
AK $692KY $204
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.